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School nurse OD'ed my kid on insulin AGAIN!(very long vent)

Discussion in 'Parents of Children with Type 1' started by Becky Stevens mom, Jan 14, 2011.

  1. Connie(BC)Type 1

    Connie(BC)Type 1 Approved members

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    Great advice, but I'd STILL write her up, and ask her if she can follow orders and read english!


    Sorry this happened Becky
     
  2. quiltinmom

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    That totally stinks. I'm glad he was okay. I'd be super mad if something like this had happened to my DS.

    Does he have any "say" in the insulin he gets? As in, if he makes suggestions, does she listen to him? My almost 9 year old can communicate some of his care to the nurse. In other words, if she wanted to give him too much insulin, he might be able to recognize it. He wouldn't be able to take care of his D without her help just yet, but he's learning. I'm guessing your son is in a similar situation.

    In addition to talking with the nurse, you can also teach your son to stop her and ask her to call you if something doesn't seem right. It would be a good idea to get him in the habit of double-checking the doses he gets at school. I'm not saying you should put this all on him, or that he is in any way at fault (have no doubt--I put all fault on the nurse), but I think he's old enough to sense when something isn't quite right. (Hard for shy kids to do, I know!) At this age, they need to know that they can speak up if something isnt' right, and that checking with mom is never a bad idea. You could also talk to his teacher about what treats given in class require treatment, which ones don't.

    (Okay, after writing all this, I see others have already said most of this...but I'm posting it anyway. :) )
     
  3. Beach bum

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    Ugh. Glad Steven is ok.

    I think I would definitely contact the district nurse about this, and figure out how your son can be kept safe under this persons care.
    Can you get written orders from your endo stating what you have repeatedly told her, ie. no corrections for bg's at snack time?

    I know at our school, snack/lunch/snack are pretty close together, definitely not the desired 2.5 hours apart, so even we, who pump, are conservative on our corrections. It's just too close for comfort and we would be stacking.

    Does she physically give Steven the shots, or does he do it under her care? I'm just thinking you can get him to call you to confirm numbers/dosing etc. Either way, for a while, this woman needs to contact you before every dose after this mistake.
     
  4. Becky Stevens mom

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    Thanks Dave:cwds: It says throughout Steven's health plan to call a parent if any questions and Ive told her that we would prefer that. There's a part in there that says that we want Steven to be part of any and all extra food activities, ie birthday parties, popcorn parties, etc and need to be called if we are not aware of this before hand. She is supposed to call if BG is over 250 at snack to get further instructions (written into the plan) , he was 274 this morning. As far as gym days, its not written into the plan but is something we've talked about alot as activity has always been real good for Steven as far as bringing BGs down. I hate to say this but Im not exactly sure that she's ever really read through his health plan. I know that seems pretty strange but she's asked questions before that are written in there and I will say, "oh thats in Steven's health plan"
     
  5. Becky Stevens mom

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    Steven tests his blood and then tells the nurse what his BG is. She will tell him the dosage of insulin that she thinks he should get and he gets the pen ready for the shot. She gives the injections. I spoke to Steven about this now that hes feeling better. He told me that after the teacher had told him that he would be getting the popcorn for the good test score ( I agree with Joan, I do NOT like food being given as rewards. These are children, not dogs) He asked to go to the nurse himself. He has been told that if he is going to eat extra food to go to the nurse to check blood and or get extra insulin if needed. Its hard to know if he's old enough yet to realize that he didnt need more insulin as he had just had a dose 1/2 hour before. He's also unsure of carb counts. The nurse has a computer right there though so should be able to punch up the carb counts on a cup of popcorn rather quickly, or, if she really is too busy (small school, less then 300 kids) call me. I would so much rather have her call me and let me handle it then just wing it like that, which is pretty much what she did.
     
  6. Flutterby

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    Did she pull the 1u of insulin for the 1/2c of popcorn out of her butt? Do you normally bolus for popcorn, especially that little bit?

    I would document what she did wrong, definitely.
     
  7. Lisa P.

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    Have you talked to her yet?

    I was all with Karla and about to organize the torches and pitchforks for you, but just read the post before this and I wonder -- any chance she found on her computer carb counts for a 1/2 cup of unpopped popcorn!??! In which case, it's not willful disregard, just a huge oops? (although not calling you about the high at snack time still seems like a disregard to me. . . . ):(:eek:
     
  8. lil'Man'sMom

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    Becky - I am so sorry that this nurse feels like she can just totally ignore the 504 and like Kim asked, did she pull the popcorn dose out of her butt.

    I am glad Steven is feeling better.
     
  9. Becky Stevens mom

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    I just asked Steven about this and he said that he showed her the bowl that the popcorn was going to be put in, small bowl, would hold about 1/2-1 cup of popped popcorn. She then looked in a book that she has there (may be Calorie King:confused:) and decided on 1 unit dose. I still wish she'd called to say that he was eating something extra :(
     
  10. chbarnes

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    1.Some kids, mine included, will spike very high after a meal, even if pre bolused for the correct amount. They then return to baseline without extra insulin. I'm not sure even every parent of a CWD realizes that.
    2. A lot of novices have been caught by the carb count of unpopped popcorn and used it for popped corn (why do they give the counts for unpopped corn?).
    She should have called you, but thought she understood how to manage the situation. You need to let her know what happened, but if you maintain your composure she will probably feel worse, and pay more attention, than if you show your anger. Few people are improved by a scolding.

    If she won't listen, or defends her actions, file a complaint.
     
  11. mom2Hanna

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    I am so sorry you have to deal with that woman for 2 1/2 more years Becky. :(
     
  12. LARSMS

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    I am glad your son is ok. I can imagine the combination of fear, anguish and anger you must have felt.

    I agree with the above approach but I would suggest doing it in writing. You may want to write a non-accusatory email describing in detail what happened and reiterating that you need to be called before extra food is given and that you should be called for any corrections as outlined in your 504 or health plan. I would suggest that any further communication about your son's care be handled via email or any phone conversation be confirmed via email. Hopefully this will clarify any confusion (if there is any in the nurse's mind), it will ensure there is no "she said, she said" and if you find you have to escalate this in the future you will have your ducks in a row.
     
  13. Mimi

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    Becky, I'm so sorry this happened.

    Glad to hear that Steven recovered well and is doing fine now.
     
  14. Tiff's mom

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    Becky, I'm sorry you guys had such a horrible day, I too hate seeing them feeling so sick, especially if you know it could have been avoided,
    I agree with everybody who suggested that you should have the nurse call you every time the decision is to be made on carbs or insulin.
    Our nurse is great, but unfortunately sometimes she can get very busy or distracted and things may happen, It's only second year for us and we have a good relationship with the nurses but they call me every single time the BG is checked, any food is eaten or the pump alarms, I just see so many variables with D that same daily routine and same food can have totally different results BG wise, so the only option I'm comfortable with is her calling me.
    PS. My son has 2 nurses at school and a 1 on 1 para whose daughter is diabetic, I'm sure if for whatever reason I couldn't get to the phone, between the 3 of them, they would figure out what to do, but I just feel more comfortable knowing what's going on...

    I'm glad Steven is feeling better, I'm sure you'll work it out with her.
     
  15. tammyjoa

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    Ok, A few things .. I am new so i could be wrong, but.. 3 cups of popcorn is only 15 carbs, so 1/2 cup is so low there should have not been any correction to begin with right? with lunch just a short time befor the popcorn was given his insulin from lunch should have coved that? and 2 i have only been doing this a month today. and i will tell ya. i have cussed out the school nurse 3 times already including today because once again she gave jordan juice while jordan was on target 80-150.. she was 113.. so there was no need for juice.. and last week she told jordan she did not need a snack at 11 am when her bg was 82 and lunch was still a hour and 15 away... dahhh give my child what i tell you to give her. if not, i will have this school and the whole staff on the 10 oclock news. so fast it will make ur head spin... :mad:

    ___________
    mom to jordan
    dx12-13-2010
    humalog and lantus
     
  16. Melissata

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    Instead of asking her to call you for everything, you could do what I did in the same situation for my daughter. Get him a cell phone and have him call you for instructions. I went through hell for years dealing with incompetent special ed teachers and aides before I finally had had all that I could take of their "mistakes". We got her the cell phone and had it written in to her IEP, you would do the same with the 504. One of the best decisions that I ever made for her and for my own sanity!
     
  17. mom2two

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    I would file a report and go to the head of the school district. I also would NOT let her touch my sons insulin ever again. Its almost like she is just guessing as to what he should get and paying no attention to anything you are saying. Does he really need a snack in the a.m.? If not I would give it up until you get this all worked out and just make sure you can be there for the lunch dose.
     
  18. CassiesMama

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    Becky, first off glad Steven is feeling better now :D As for that air headed nurse I would still file a complaint with her supervisors. A mistake happens once,and you learn from it and don't do it again. If it happens again its just willful disregard for the health plan, and should not be tolerated. Maybe if her bosses remind her that she needs to read the 504 and follow it, she might improve.
     
  19. Mom2Will

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    Having dealt with someone this year that felt she knew more than I about Will's diabetes:

    Make a written note to her (always get it in writing, it might come in handy later, so I've learned)and keep a copy. Start writing notes about everything, every day if you must. This is the nice way. When she continues to disregard you and your notes, file a complaint, call the principal, call every day. Put in the note that you WANT to be called about a correction BEFORE insulin is given. Send a note with "snack 25 carbs" every day then she can't say you aren't doing what she wanted. Put your phone number on every note then she can't say she didn't feel she had time to look up your number.

    I feel your pain, been there, done that. You're a good mom!
     
  20. Gomod71

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    Becky, so sorry to hear of your troubles.

    I have gone through a lot of battles with our school nurse in the past 2 1/2 years and this year finally things have gotten better.

    Alexander's favorite line is "you'd better call mom" - he uses it all the time - whether with my husband, my mother, or the school nurse. I have drilled it into his head that I make the final call on anything. Thankfully, most of the time it's more for reassurance than actually giving instructions, he's taken ownership of his diabetes much more so these days.

    I also have it clearly written into his 504 plan that he is allowed to contact me at anytime to consult about his diabetes. No one has given him a hard time about that at all. He usually uses the school phone but has permission to call me on his cell if he prefers.

    I suppose if the nurse can't follow the health plan instructions though, trying to get her to follow a 504 might be somewhat of a challenge.

    I don't buy that it was a mistake though. I think it's neglect -whether it be willful or not, she cannot be making the decision on Steven's treatment. My nurse has used the line "well ... that's standard nursing protocol" before on me and I've laid down the law and said "follow the drs orders - period!"

    I can understand how you don't want to put her on the defensive, but somehow you need to get through to her that what she's done is dangerous. Who is her supervisor? The principal or the superindendent of schools? Go through the proper channels if you cannot feel you can speak to her, but don't be hesitant to take it to a higher authority. Steven's safety and health and your own trust in her takes precident.

    Good luck - and HUGS to you!
     

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